Cargando…
Laparoscopic Cholecystectomy for Gallbladder Dysfunction and Polyps: Incidence and Follow up
AIM: This study aims to evaluate the incidence, indications, management, and long term follow up of cholecystectomy in patients with no gallstones, other than acalculous acute cholecystitis. METHODS: Prospectively collected data of 5675 patients undergoing laparoscopic cholecystectomy (LC) over 28 y...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Society of Laparoendoscopic Surgeons
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8088335/ https://www.ncbi.nlm.nih.gov/pubmed/33981137 http://dx.doi.org/10.4293/JSLS.2021.00009 |
_version_ | 1783686827680464896 |
---|---|
author | Qandeel, Haitham Nassar, Ahmad H. M. Ng, Hwei J. El Zanati, Hisham |
author_facet | Qandeel, Haitham Nassar, Ahmad H. M. Ng, Hwei J. El Zanati, Hisham |
author_sort | Qandeel, Haitham |
collection | PubMed |
description | AIM: This study aims to evaluate the incidence, indications, management, and long term follow up of cholecystectomy in patients with no gallstones, other than acalculous acute cholecystitis. METHODS: Prospectively collected data of 5675 patients undergoing laparoscopic cholecystectomy (LC) over 28 years was extracted and analyzed. Patients with biliary symptoms, no stones on ultrasound scans and abnormal hepatobiliary iminodiacetic acid scans, and those with confirmed gallbladder polyps (GBP) were included. RESULTS: Two percent of cholecystectomies were performed in patients with acalculous pathology [1.3% functional gallbladder disorder (FGBD) and 0.7% GBP]. The 114 patients were younger, had lower American Society of Anesthesiologists classification, and had fewer previous biliary admissions than those with gallstones (5560). The clinical presentations of FGBD were chronic biliary symptoms (93.1%) and acute biliary pain (6.9%). GBP patients presented with chronic biliary symptoms. LC in 98.6% FGBD and 92.8% GBP were significantly easier than those for gall stones (P < 0.0001). They were significantly (P < 0.0001 FGBD and P < 0.001 GBP) less likely to have adhesions to the gallbladder. This ease was reflected in shorter operation times and lower utilization of abdominal drains. Polyp numbers ranged from 1 to 30 and sizes from 1 mm to 11 mm. No malignant polyps were encountered. In 95.8% FGBD and 95% GBP, patients had a good symptomatic response to LC. CONCLUSIONS: FGBD and GBP are uncommon in patients undergoing LC. FGBD should be considered during evaluation of right upper quadrant pain with no gall stones. Laparoscopic cholecystectomy may be considered as it achieves long term symptomatic relief in most patients with FGBD and GBP. |
format | Online Article Text |
id | pubmed-8088335 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Society of Laparoendoscopic Surgeons |
record_format | MEDLINE/PubMed |
spelling | pubmed-80883352021-05-11 Laparoscopic Cholecystectomy for Gallbladder Dysfunction and Polyps: Incidence and Follow up Qandeel, Haitham Nassar, Ahmad H. M. Ng, Hwei J. El Zanati, Hisham JSLS Research Article AIM: This study aims to evaluate the incidence, indications, management, and long term follow up of cholecystectomy in patients with no gallstones, other than acalculous acute cholecystitis. METHODS: Prospectively collected data of 5675 patients undergoing laparoscopic cholecystectomy (LC) over 28 years was extracted and analyzed. Patients with biliary symptoms, no stones on ultrasound scans and abnormal hepatobiliary iminodiacetic acid scans, and those with confirmed gallbladder polyps (GBP) were included. RESULTS: Two percent of cholecystectomies were performed in patients with acalculous pathology [1.3% functional gallbladder disorder (FGBD) and 0.7% GBP]. The 114 patients were younger, had lower American Society of Anesthesiologists classification, and had fewer previous biliary admissions than those with gallstones (5560). The clinical presentations of FGBD were chronic biliary symptoms (93.1%) and acute biliary pain (6.9%). GBP patients presented with chronic biliary symptoms. LC in 98.6% FGBD and 92.8% GBP were significantly easier than those for gall stones (P < 0.0001). They were significantly (P < 0.0001 FGBD and P < 0.001 GBP) less likely to have adhesions to the gallbladder. This ease was reflected in shorter operation times and lower utilization of abdominal drains. Polyp numbers ranged from 1 to 30 and sizes from 1 mm to 11 mm. No malignant polyps were encountered. In 95.8% FGBD and 95% GBP, patients had a good symptomatic response to LC. CONCLUSIONS: FGBD and GBP are uncommon in patients undergoing LC. FGBD should be considered during evaluation of right upper quadrant pain with no gall stones. Laparoscopic cholecystectomy may be considered as it achieves long term symptomatic relief in most patients with FGBD and GBP. Society of Laparoendoscopic Surgeons 2021 /pmc/articles/PMC8088335/ /pubmed/33981137 http://dx.doi.org/10.4293/JSLS.2021.00009 Text en © 2021 by SLS, Society of Laparoscopic & Robotic Surgeons. https://creativecommons.org/licenses/by-nc-nd/3.0/us/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License (http://creativecommons.org/licenses/by-nc-nd/3.0/us/ (https://creativecommons.org/licenses/by-nc-nd/3.0/us/) ), which permits for noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited and is not altered in any way. |
spellingShingle | Research Article Qandeel, Haitham Nassar, Ahmad H. M. Ng, Hwei J. El Zanati, Hisham Laparoscopic Cholecystectomy for Gallbladder Dysfunction and Polyps: Incidence and Follow up |
title | Laparoscopic Cholecystectomy for Gallbladder Dysfunction and Polyps: Incidence and Follow up |
title_full | Laparoscopic Cholecystectomy for Gallbladder Dysfunction and Polyps: Incidence and Follow up |
title_fullStr | Laparoscopic Cholecystectomy for Gallbladder Dysfunction and Polyps: Incidence and Follow up |
title_full_unstemmed | Laparoscopic Cholecystectomy for Gallbladder Dysfunction and Polyps: Incidence and Follow up |
title_short | Laparoscopic Cholecystectomy for Gallbladder Dysfunction and Polyps: Incidence and Follow up |
title_sort | laparoscopic cholecystectomy for gallbladder dysfunction and polyps: incidence and follow up |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8088335/ https://www.ncbi.nlm.nih.gov/pubmed/33981137 http://dx.doi.org/10.4293/JSLS.2021.00009 |
work_keys_str_mv | AT qandeelhaitham laparoscopiccholecystectomyforgallbladderdysfunctionandpolypsincidenceandfollowup AT nassarahmadhm laparoscopiccholecystectomyforgallbladderdysfunctionandpolypsincidenceandfollowup AT nghweij laparoscopiccholecystectomyforgallbladderdysfunctionandpolypsincidenceandfollowup AT elzanatihisham laparoscopiccholecystectomyforgallbladderdysfunctionandpolypsincidenceandfollowup |